Individual
LYA J BURGESS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSW/LICSW
Contact information
Practice address
200 NORTH ST, SUITE 101, NEW MARTINSVILLE, WV 26155-1784
(304) 771-8837
Mailing address
200 NORTH ST, SUITE 101, NEW MARTINSVILLE, WV 26155-1784
(304) 771-8837
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
—
—
Other
Enumeration date
06/19/2008
Last updated
05/07/2015
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